0001181431-13-025434.txt : 20130506 0001181431-13-025434.hdr.sgml : 20130506 20130506153626 ACCESSION NUMBER: 0001181431-13-025434 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130506 FILED AS OF DATE: 20130506 DATE AS OF CHANGE: 20130506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Grasher Michael F CENTRAL INDEX KEY: 0001575709 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12251 FILM NUMBER: 13815955 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERISAFE INC CENTRAL INDEX KEY: 0001018979 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 752069407 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 BUSINESS PHONE: 337-463-9052 MAIL ADDRESS: STREET 1: 2301 HIGHWAY 190 WEST CITY: DERIDDER STATE: LA ZIP: 70634 4 1 rrd378638.xml FORM 4 X0306 4 2013-05-06 0 0001018979 AMERISAFE INC AMSF 0001575709 Grasher Michael F 2301 HIGHWAY 190 WEST DERIDDER LA 70634 0 1 0 0 Exectuive Vice President Common Stock, par value $0.01 2013-05-06 4 A 0 26137 0 A 26137 D /s/ Michael F. Grasher 2013-05-06